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胫骨平台骨折切开复位内固定术后手术部位感染的发生率及危险因素:系统评价和荟萃分析。

Incidence and risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture: A systematic review and meta-analysis.

机构信息

The Third Hospital of Hebei Medical University, Orthopaedic Surgery, NO. 139 Ziqiang Road, Shijiazhuang, Hebei, 050051, People's Republic of China; Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Surgery, NO. 139 Ziqiang Road, Shijiazhuang, Hebei, 050051, People's Republic of China.

出版信息

Int J Surg. 2017 May;41:176-182. doi: 10.1016/j.ijsu.2017.03.085. Epub 2017 Apr 4.

Abstract

BACKGROUND

This study aimed to quantitatively summarize the risk factors associated with surgical site infection after open reduction and internal fixation of tibial plateau fracture.

METHODS

Medline, Embase, CNKI, Wanfang database and Cochrane central database were searched for relevant original studies from database inception to October 2016. Eligible studies had to meet quality assessment criteria according to the Newcastle-Ottawa Scale, and had to evaluate the risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture. Stata 11.0 software was used for this meta-analysis.

RESULTS

Eight studies involving 2214 cases of tibial plateau fracture treated by open reduction and internal fixation and 219 cases of surgical site infection were included in this meta-analysis. The following parameters were identified as significant risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture (p < 0.05): open fracture (OR 3.78; 95% CI 2.71-5.27), compartment syndrome (OR 3.53; 95% CI 2.13-5.86), operative time (OR 2.15; 95% CI 1.53-3.02), tobacco use (OR 2.13; 95% CI 1.13-3.99), and external fixation (OR 2.07; 95% CI 1.05-4.09). Other factors, including male sex, were not identified as risk factors for surgical site infection.

CONCLUSION

Patients with the abovementioned medical conditions are at risk of surgical site infection after open reduction and internal fixation of tibial plateau fracture. Surgeons should be cognizant of these risks and give relevant preoperative advice.

摘要

背景

本研究旨在定量总结胫骨平台骨折切开复位内固定术后手术部位感染的相关危险因素。

方法

检索 Medline、Embase、中国知网、万方数据库和 Cochrane 中心数据库,检索时间从数据库建立至 2016 年 10 月,收集胫骨平台骨折切开复位内固定术后手术部位感染的相关原始研究。纳入的研究均需按照纽卡斯尔-渥太华量表(Newcastle-Ottawa Scale)进行质量评价,且需评估胫骨平台骨折切开复位内固定术后手术部位感染的危险因素。使用 Stata 11.0 软件进行荟萃分析。

结果

共纳入 8 项研究,包括 2214 例胫骨平台骨折切开复位内固定术患者和 219 例手术部位感染患者。结果显示,以下参数是胫骨平台骨折切开复位内固定术后手术部位感染的显著危险因素(p<0.05):开放性骨折(OR 3.78;95% CI 2.71-5.27)、骨筋膜室综合征(OR 3.53;95% CI 2.13-5.86)、手术时间(OR 2.15;95% CI 1.53-3.02)、吸烟(OR 2.13;95% CI 1.13-3.99)和外固定(OR 2.07;95% CI 1.05-4.09)。其他因素,如男性,不是手术部位感染的危险因素。

结论

患有上述疾病的患者,胫骨平台骨折切开复位内固定术后发生手术部位感染的风险较高。外科医生应意识到这些风险,并给予相关的术前建议。

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